Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.
Bipolar Disord. 2022 Jun;24(4):375-391. doi: 10.1111/bdi.13130. Epub 2021 Oct 1.
Increasing evidence supports a bidirectional relationship between major depressive disorder (MDD) and obesity, but the role of visceral adipose tissue (VAT) as a measure of obesity in relation to MDD is not well understood. Here we review literature investigating the link between MDD and VAT in terms of biomarkers, sex differences, and aging.
PubMed, EMBASE, PsycINFO, and CINAHL searches were conducted on December 11, 2020. No date or language limits were imposed. Major concepts searched were Depressive Disorder linked with Adipose Tissue, White, Hypothalmo-Hypophyseal System, and Pituitary-Adrenal System in addition to keywords. A final set of 32 items meeting criteria for inclusion.
Converging biological evidence suggests a significant bidirectional relationship between VAT and MDD across the lifespan. In adulthood, greater VAT was associated with increased risk for depression, especially in vulnerable groups such as individuals who are overweight/obese, postmenopausal women, and individuals with comorbid medical or psychiatric illness. In older adults, sarcopenia had an impact on the relationship between abnormal VAT and risk of depression. Additionally, sex differences emerged as a potential factor affecting the strength of the association between VAT and depression.
Elucidating the pathophysiological mechanisms associated with increased rates of depression in obese individuals will be crucial for developing specific treatment strategies that seek to improve outcomes in individuals with comorbid depression and obesity. Moreover, identifying age- and sex-specific risk factors may contribute to a more personalized medicine approach, thereby improving the quality of clinical care.
越来越多的证据支持重度抑郁症（MDD）与肥胖之间存在双向关系，但肥胖的内脏脂肪组织（VAT）作为 MDD 相关指标的作用尚不清楚。在这里，我们综述了有关 MDD 与 VAT 之间在生物标志物、性别差异和衰老方面联系的文献。
我们于 2020 年 12 月 11 日在 PubMed、EMBASE、PsycINFO 和 CINAHL 上进行了文献检索，未设置日期或语言限制。除了关键词外，还搜索了与“Depressive Disorder 与 Adipose Tissue，White，Hypothalmo-Hypophyseal System，和 Pituitary-Adrenal System 相关”这一主要概念有关的文献。最后有 32 篇符合纳入标准的文章。
一致的生物学证据表明，VAT 与 MDD 之间存在贯穿整个生命周期的显著双向关系。在成年期，更多的 VAT 与抑郁风险增加相关，尤其是在超重/肥胖、绝经后妇女和患有合并症的医学或精神疾病的人群等脆弱群体中。在老年人中，肌肉减少症对异常 VAT 与抑郁风险之间的关系有影响。此外，性别差异也成为影响 VAT 与抑郁之间关联强度的一个潜在因素。
阐明与肥胖个体中抑郁发生率增加相关的病理生理机制对于开发特定的治疗策略至关重要，这些策略旨在改善合并有抑郁和肥胖的个体的结局。此外，确定年龄和性别特异性的风险因素可能有助于实现更个体化的医学方法，从而提高临床护理质量。
